Autonomic sympathetic nerve involvement in diabetic impotence

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Abstract
Sympathetic skin potentials (SSP) were evoked by peripheral nerve stimulation of the hands, feet, and genital skin of 49 diabetics with erectile impotence. Eight potent diabetic men were used as controls. The bulbocavernosus reflex latency (BCR) was also recorded from all patients. The BCR was prolonged in 31% of impotent patients, while the SSP were absent in the genital skin in 47%. Fifty nine percent had either prolonged BCR or absent SSP. In 12 patients with “subacute impotence” the electrophysiological findings were abnormal in 10 (83%). In 37 patients with slowly progressive impotence, 51% had electrophysiological abnormalities.It was concluded that pelvic‐autonomic neuropathy is one of the major contributing factors in the pathogenesis of diabetic erectile impotence, especially in the subacutely developing cases; however, neuropathic and vascular factors probably both play a part in the pathogenesis of impotence in the majority of cases with a slowly progressive course.